Individual
THEODORE E ATKINSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1319 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-3900
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
09070
MS
208000000X
Pediatrics Physician
310957
LA
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
310957
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119545
—
MS
05
—
1425494
—
LA
01
—
1559127
AMERICAN ADMIN GROUP
MS
01
—
370011648
RAILROAD MEDICARE
—
Enumeration date
07/27/2006
Last updated
10/31/2018
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